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Preoperative neuropathic pain like symptoms and central pain mechanisms in knee osteoarthritis predicts poor outcome 6 months after total knee replacement surgery

Kurien, Thomas; Arendt-Nielsen, Lars; Petersen, Kristian K; Graven-Nielsen, Thomas; Scammell, Brigitte E.

Authors

Thomas Kurien

Lars Arendt-Nielsen

Kristian K Petersen

Thomas Graven-Nielsen

Brigitte E. Scammell



Abstract

Preoperative pain characteristics in osteoarthritis (OA) patients may explain persistent pain after total knee replacement (TKR). Fifty patients awaiting TKR and 22 asymptomatic controls were recruited to evaluate the degree of neuropathic pain symptoms and pain sensitisation. OA patients were pain phenotyped into two groups based on the PainDETECT questionnaire: High PainDETECT group (scores ≥19) indicating neuropathic pain-like symptoms, Low PainDETECT group (scores 19) indicating nociceptive or mixed pain.

Cuff algometry assessing pain detection thresholds (PDT) and pain tolerance (PTT) was conducted on the lower legs. Temporal summation of pain (TSP) was assessed using ten sequential cuff stimulations and a von Frey stimulator. Conditioning pain modulation was assessed by cuff pain conditioning on one leg and parallel assessment of PDT on the contralateral leg. Pressure pain thresholds (PPTs) were recorded by pressure handheld algometry local and distant to the knee. Knee pain intensity (VAS) and pain assessment were collected before and 6 months post-TKR. 30% of patients demonstrated neuropathic pain-like symptoms (High PainDETECT group). Facilitated TSP and reduced PPTs distant to the knee were found in High PainDETECT group compared to Low PainDETECT group and healthy controls groups (p

Journal Article Type Article
Publication Date Jul 18, 2018
Journal The Journal of Pain
Print ISSN 1526-5900
Electronic ISSN 1528-8447
Publisher Elsevier
Peer Reviewed Peer Reviewed
APA6 Citation Kurien, T., Arendt-Nielsen, L., Petersen, K. K., Graven-Nielsen, T., & Scammell, B. E. (2018). Preoperative neuropathic pain like symptoms and central pain mechanisms in knee osteoarthritis predicts poor outcome 6 months after total knee replacement surgery. Journal of Pain, doi:10.1016/j.jpain.2018.05.011. ISSN 1526-5900
DOI https://doi.org/10.1016/j.jpain.2018.05.011
Keywords Anesthesiology and Pain Medicine; Neurology; Clinical Neurology
Publisher URL https://www.sciencedirect.com/science/article/pii/S1526590018302918

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